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CME: Therapeutic Updates, Best Practices, and Barriers to Care in the Treatment of Chronic Pain

Activity Description / Statement of Need:

Chronic pain is a serious medical condition found in a diverse range of patient populations.  Because of the etiologically heterogeneous nature of this condition, many treatment modalities exist, some of which apply to a broader range of patient populations than do others.  For several reasons that are both patient- and provider-specific and include concern over medication dependence, stigma to narcotic use, and the inherent difficulty in measuring the subjective phenomenon of pain itself, chronic pain is frequently undertreated.


Opioids are a mainstay of pharmacologic care for non-neuropathic chronic pain and are available in many dosage forms with novel routes of administration, adding a layer of complexity to their prescription.  There are also many products combining opioids with other medications providing an additional set of therapeutic options.  These dual products may either contain synergistic combinations of medications for added efficacy or agonist-antagonist combinations meant to reduce abuse potential or side effects.


Healthcare professionals must navigate an array of regulations specifically aimed at the prescription of controlled substances when managing chronic pain, and the uninformed may skirt or traverse the law, whether intentionally or not, when they prescribe analgesics. 


Because extended-release medications are the most likely to be abused due to increased potency, additional education should be provided and caution used when prescribing them.  The FDA is seeking ways to make these medications safer but, in the mean time, stronger caution may be needed on the part of prescribers. 


The literature suggests that: there are or may be emerging or existing patterns of racial and ethnic disparities in healthcare and treatment of patients with chronic pain; race- and ethnicity-based discrimination within the healthcare environment are associated with disparities in care; and that such discrimination is associated with both worse chronic health condition control and a higher incidence catastrophic health events.


Taken in aggregate, these factors suggest that a gap exists between best practices and actual medical practice; they also highlight the importance of considering alternatives to opioid therapy when appropriate.  This program has been designed to bring healthcare professionals’ knowledge of the strategies for management of chronic pain up to date.  The program also attempts to examine the role of demographic-based barriers to care of patients with chronic pain and strategies to minimize or alleviate those disparities.




  • Introduction, Disclosures
  • Epidemiology of chronic pain
  • Clinical features of chronic pain Treatment of chronic pain
  • Barriers to optimal care in patients with chronic pain
  • Summary, conclusions, and best practice recap

Target Audience:

Healthcare professionals specializing in anesthesiology, dentistry, emergency medicine, family medicine, internal medicine, neurology, oncology, pain management, palliative care, primary care, psychiatry, public health, surgery, or those who otherwise commonly care for patients with chronic pain or who frequently encounter individuals with substance abuse disorders in practice.

Commercial Support Disclosure: This program is supported by  educational grants from Purdue Pharma L. P.

Release Date: January 08, 2013 -- Expiration Date: January 08, 2015

Faculty: Chris Herndon, PharmD


Learning Objectives

By the end of the session the participant will be able to:

  • Describe challenges to the successful management of chronic pain.
  • Apply existing diagnostic recommendations and criteria to practice in the management of chronic pain.
  • Develop strategies to minimize adverse effects associated with chronic pain treatment in different patient populations.
  • `Develop a monitoring plan aimed at streamlining therapeutic titration of chronic pain treatment in different patient populations.



Faculty Disclosure and Resolution of COI


As an provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is our policy to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Faculty Disclosure: Chris Herdon, PharmD reports that he is a consultant for Premier Research Collaborotive and a member of Advisory Boards for Endo and Incline.

Disclosures of Educational Planner: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC. ScientiaCME has received grants from Novo Nordisk, the commercial supporter of this program.

Commercial Support Disclosure: This program is supported by  educational grants from Purdue Pharma L. P.




  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.